| Ascension Medical Group-fox Valley Wisconsin, Inc | |
|
1160 Service Rd Kiel WI 53042 | |
| (920) 894-3322 | |
| Not Available |
| Full Name | Ascension Medical Group-fox Valley Wisconsin, Inc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 1160 Service Rd, Kiel, Wisconsin |
| Authorized Official Name and Position | J. Bryan Fissel (VP-FINANCE) |
| Authorized Official Contact | 4144653000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ascension Medical Group-fox Valley Wisconsin, Inc 1160 Service Rd Kiel WI 53042-1281 Ph: (920) 738-2000 | Ascension Medical Group-fox Valley Wisconsin, Inc 1160 Service Rd Kiel WI 53042 Ph: (920) 894-3322 |
| NPI Number | 1437317708 |
|---|---|
| Provider Enumeration Date | 05/23/2008 |
| Last Update Date | 03/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437317708 | NPI | - | NPPES |
| 32752000 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Mh Health Care Services, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Persnickety Pl, Kiel, WI 53042 Phone: 888-893-6141 |